Tag Archives: risk adjustment

Amid ACA Uncertainty, Covered California’s Risk Profile Remains Stable

One of the constant concerns about the ACA and the status of the exchanges involves the average health status of enrollees in these state Marketplaces. Results reveal encouraging news, for amid talk of death spirals, it suggests Covered California continues to attract a healthy mix of enrollees.

May 15, 2017

Capping Enrollment To Save Minnesota’s Individual Market

Minnesota struck a deal with five health plans in the state’s individual market to prevent a market collapse. In June, BCBS announced that it was leaving the individual market with 103,000 individuals left to find a new plan November 1st. It was feared that other plans would quickly follow suit.

October 18, 2016

A Friendly Competition To Increase ACA Marketplace Stability: Calling All Actuaries

Without a doubt, the next administration and Congress will face difficult decisions about how best to address the challenges facing the individual health insurance market. The Robert Wood Johnson Foundation is sponsoring a competition for teams of actuaries to develop solutions to improve that...

October 11, 2016

Judge Rules In ACA Premium Stabilization Program Case; New Hardship Exemption

On August 12, federal judge Rebecca Ebinger entered the first decision in one of the growing number of cases challenging the administration of the premium stabilization programs, denying a motion for a preliminary injunction. CMS also announced a new hardship exemption to the individual mandate.

August 15, 2016

Struggling To Stabilize: 3Rs Litigation And The Future Of The ACA Exchanges

One day, ACA Marketplace plans may cover many of the 11 percent of Americans who remain uninsured. But the three programs---reinsurance, risk corridors, and risk adjustment---that the ACA’s drafters hoped would help stabilize premiums in the revamped markets have not performed as expected.

August 1, 2016

How Funders Can Support Emerging Accountable Care Organizations To Maximize Their Potential

Foundations and others can partner with policy makers and researchers to play a critical role in addressing the remaining challenges for ACOs and in supporting the evolution of promising ACO models.

January 5, 2016

Implementing Health Reform: New CMS Guidance And First-Year Results (Northern Arapaho Tribe v. Burwell Update)

CMS recently announced the results from the SHOP exchange, reinsurance, and risk adjustment programs. Judge Scott Skavdahl of the United States District Court for the District of Wyoming also dismissed a lawsuit brought by the Northern Arapaho Tribe in which the Tribe claimed that it was exempt...

July 1, 2015